Cao Hui-Xia, Zhao Xin-di, Yan Lei, Fan Xiao-Guang, Shao Feng-Min
Department of Nephrology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China.
Medicine (Baltimore). 2019 Feb;98(6):e14376. doi: 10.1097/MD.0000000000014376.
There are few studies on the correlation between red blood cell distribution width (RDW) and cardiovascular events in the patients receiving peritoneal dialysis (PD). We explored the correlation between RDW and cardiovascular events in PD patients and possible mechanism.A total of 138 PD patients were divided into RDW < 15% group (n = 104) and RDW ≥ 15% group (n = 34).The levels of serum C-reactive protein (CRP) [3.05 (0.79, 15.30) mg/L vs 2.15 (1.00, 6.50) mg/L] and parathyroid hormone (PTH) [260.0 (192.7, 352.6) ng/L vs 200.7 (118.0, 319.7) ng/L] were significantly higher, but the levels of serum albumin [30.65 (27.4,32.8) g/L vs 32.3 (29.25,34.95) g/L], prealbumin [(299 ± 96) g/L vs (346 ± 86) g/L], triglyceride [1.24 (0.72, 1.50) mmol/L vs 1.42 (1.12,1.84) mmol/L], and transferrin saturation [27.9 (16.4, 43.6)% vs 37.8 (23.3, 57.2)%] were significantly lower in the RDW ≥ 15% group than in the RDW < 15% group (all P < 0.05). The RDW was negatively correlated with albumin (r = - 0.258, P = 0.002), prealbumin (r = -0.236, P = 0.005), and triglyceride (r = -0.194, P = 0.023), but was positively correlated with CRP level (r = 0.174, P = 0.041). The incidence of cardiovascular events was significantly higher in the RDW ≥ 15% group (6 patients, 17.6%) than in the RDW < 15% group (6.7%) (7 patients, P < 0.01). Cox proportional hazard model showed that elevated RDW level was an independent risk factor for cardiovascular events in PD patients (HR = 1.622, 95% CI: 1.063-2.475, P = 0.025).The elevated RDW may be served as a risk factor to predict the cardiovascular events in PD patients.
关于接受腹膜透析(PD)患者的红细胞分布宽度(RDW)与心血管事件之间相关性的研究较少。我们探讨了PD患者中RDW与心血管事件之间的相关性及可能机制。共138例PD患者被分为RDW<15%组(n = 104)和RDW≥15%组(n = 34)。RDW≥15%组的血清C反应蛋白(CRP)水平[3.05(0.79,15.30)mg/L对2.15(1.00,6.50)mg/L]和甲状旁腺激素(PTH)水平[260.0(192.7,352.6)ng/L对200.7(118.0,319.7)ng/L]显著更高,但血清白蛋白水平[30.65(27.4,32.8)g/L对32.3(29.25,34.95)g/L]、前白蛋白[(299±96)g/L对(346±86)g/L]、甘油三酯[1.24(0.72,1.50)mmol/L对1.42(1.12,1.84)mmol/L]和转铁蛋白饱和度[27.9(16.4,43.6)%对37.8(23.3,57.2)%]在RDW≥15%组显著低于RDW<15%组(均P<0.05)。RDW与白蛋白(r = -0.258,P = 0.002)、前白蛋白(r = -0.236,P = 0.005)和甘油三酯(r = -0.194,P = 0.023)呈负相关,但与CRP水平呈正相关(r = 0.174,P = 0.041)。RDW≥15%组心血管事件发生率(6例,17.6%)显著高于RDW<15%组(7例中的6.7%)(P<0.01)。Cox比例风险模型显示,升高的RDW水平是PD患者心血管事件的独立危险因素(HR = 1.622,95%CI:1.063-2.475,P = 0.025)。升高的RDW可能作为预测PD患者心血管事件的危险因素。